Folliculitis

Alternative names
Pseudofolliculitis barbae; Tinea barbae; Barber’s itch

Definition
Folliculitis is inflammation of one or more hair follicles. The condition may occur anywhere on the skin.

Causes, incidence, and risk factors

Folliculitis starts when hair follicles are damaged by friction from clothing, blockage of the follicle, or shaving. In most cases of folliculitis, the damaged follicles are then infected with the bacteria Staphylococcus (staph).

Barber’s itch is a staph infection of the hair follicles in the bearded area of the face, usually the upper lip. Shaving aggravates the condition. Tinea barbae is similar to barber’s itch, but the infection is caused by a fungus.

Pseudofolliculitis barbae is a disorder occurring primarily in Black men. If curly beard hairs are cut too short, they may curve back into the skin and cause inflammation.

Symptoms

     
  • rash (reddened skin area)  
  • pimples or pustules located around a hair follicle       o may crust over       o typically occur on neck axilla, or groin area       o may present as genital lesions  
  • itching skin

Signs and tests
A diagnosis is primarily based on the appearance of the skin. The skin infection is shallow and superficial. A culture of the lesion may show which bacteria or fungus are causing it.

Treatment

To prevent further damage to the hair follicles and infection:

     
  • Minimize friction from clothing.  
  • Avoid shaving the area if possible. If shaving is necessary, use a clean new razor blade or an electric razor each time.  
  • Keep the area clean.

Avoid reinfection from contaminated clothing and washcloths. Hot moist compresses may promote drainage of extensive folliculitis. Topical antibiotics (Bactroban), oral antibiotics (e.g., dicloxacillin), or antifungal medications may be needed to control the infection.

Expectations (prognosis)

Folliculitis usually responds well to treatment, but may recur.

Complications

     
  • the folliculitis may return  
  • the infection may spread to other body areas

Calling your health care provider
Apply home treatment and call your health care provider if symptoms recur frequently, if they persist longer than 2 or 3 days, or if the infection spreads.

Prevention
Avoid damage to the hair follicles to prevent infection. (See Treatment.)

Johns Hopkins patient information

Last revised: December 3, 2012
by Levon Ter-Markosyan, D.M.D.

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